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===Variable presentations=== Children younger than five years old may have atypical presentations and many of the common signs and symptoms may be missing or different. Children younger than 3 years old can present with nasal congestion and a lower grade fever.<ref name="Langlois-2011">{{cite journal | vauthors = Langlois DM, Andreae M | s2cid = 207170856 | title = Group A streptococcal infections | journal = Pediatrics in Review| volume = 32 | issue = 10 | pages = 423β9; quiz 430 | date = October 2011 | pmid = 21965709 | doi = 10.1542/pir.32-10-423 }}</ref> Infants may present with symptoms of increased irritability and decreased appetite.<ref name="Langlois-2011" />
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